IMPETIGINES. 657 



compressing it, and that arising either in the coats of the duct 

 itself, or in any of the neighbouring parts that are, or may come 

 to be contiguous to it. 



MDCCCXIX. When such obstruction happens, the secret- 

 ed bile must be accumulated in the biliary ducts ; and from 

 thence it may either be absorbed and carried by the lymphat'cs 

 into the blood-vessels, or it may regurgitate in the ducts them- 

 selves, and pass from them directly into the ascending cava. 

 In either way, it comes to be diffused in the mass of blood ; 

 and from thence may pass by every exhalent vessel, and pro- 

 duce the disease in question. 



MDCCCXX. I have thus shortly explained the ordinary 

 production of jaundice ; but it must be observed farther, that it 

 is at all times accompanied with certain other symptoms, such as 

 a whiteness of the fences alvince, which we readily account for 

 from the absence of bile in the intestines; and generally, also, 

 with a certain consistence of the faeces, the cause of which is 

 not so easy to explain. The disease is always accompanied also 

 with urine of a yellow colour, or at least with urine that tinges a 

 linen cloth with a yellow colour. These are constantly attending 

 symptoms ; and though not always, yet there is commonly, a 

 pain felt in the epigastrium, corresponding, as we suppose, to 

 the seat of the ductus communis. This pain is often accom- 

 panied with vomiting ; and even when the pain is not consider- 

 able, a vomiting sometimes occurs. In some cases, when the 

 pain is considerable, the pulse becomes frequent, full, and hard, 

 and some other symptoms of pyrexia appear. 



MDCCCXXI. When the jaundice is occasioned by tumours 

 of the neighbouring parts compressing the biliary duct, I be- 

 lieve the disease can very seldom be cured. That such is the 

 cause of jaundice, may with some probability be supposed, when 

 it has come on in consequence of other diseases which had sub- 

 sisted long before, and more especially such as had been attend- 

 ed with symptoms of obstructed viscera. Even when the 

 jaundice has subsisted long without any intermission, and with- 

 out any pain in the epigastrium, an external compression is, to 

 be suspected. 



MDCCCXXII. In such circumstances, I consider the dis- 

 ease as incurable ; and it is almost only when the disease is 

 VOL. ii. 2 T 



